Term
| All of the following must be present to have current EXCEPT |
|
Definition
a. voltage
b. conductor
*c. impedance
d. source of electrons
e. all of the above are needed |
|
|
Term
| All of the following might be expected when electricity is therapeutically applied to the body EXCEPT |
|
Definition
a. thermal effect
b. physiological effects
c. physiochemical effects
d. a and b only
*e. all of the above |
|
|
Term
| The law of Dubois Reymond says that the effectiveness of a current to target specific excitable tissues is dependent on which of these factors? |
|
Definition
a. current onset fast enough to reduce accommodation
b. adequate intensity to reach threshold
c. duration long enough to exceed the capacitance
d. none of the above
*e. all of the above |
|
|
Term
| All of the following could be considered to minimize electrode resistance EXCEPT |
|
Definition
*a. smaller electrodes
b. removal of excess hair and oil from the skin
c. even, firm, moist electrode contact with the skin
d. clean electrodes
e. all of the above |
|
|
Term
| of the following are true about the placement of electrodes EXCEPT |
|
Definition
a. when electrodes are placed close together, the current is dense in the superficial tissues
b. when electrodes are placed farther apart, the current goes deeper
*c. current density is most concentrated in the larger electrode
d. a and b only
e. none of the above |
|
|
Term
| All of the following are primary reasons for using a monopolar electrode configuration EXCEPT |
|
Definition
a. required when a polarity effect is desired
b. when using a point stimulator
c. to put electrodes farther apart for deeper penetration
d. a and c only
*e. all of the above |
|
|
Term
| Phase charge ________________________. |
|
Definition
a. is measured in microcoulombs
b. can be increased by lengthening the phase duration
c. can be increased by increasing the amplitude of the stimulus
d. a and b are correct
*e. a, b, and c are correct |
|
|
Term
| The physiological response to a monophasic and biphasic current will be the same if the _______________________ is/are the same. |
|
Definition
a. treatment frequency
b. phase charge
c. pulse charge
*d. a and b are correct
e. a, b, and c are correct |
|
|
Term
| Iontophoresis does not result in muscle contraction. This is because ____________. |
|
Definition
a. direct current cannot cause a muscle contraction
*b. the peak amplitude is below rheobase of alpha motor neurons
c. the phase duration of direct current is too short
d. iontophoresis units do not provide adequate ramp time |
|
|
Term
| You want to use IFC for sensory pain control. In selecting your parameters, you remember that the carrier frequency is fixed at 5,000. You select a treatment frequency of 80 pps. What is the frequency of the interfering wave? |
|
Definition
a. 5,080 Hz
*b. 5,080 pps
c. 4,920 Hz
d. 4,920 pps |
|
|
Term
| The capacitance of a denervated muscle is ______________ the capacitance of an alpha motor neuron. |
|
Definition
a. less than
*b. greater than
c. the same as |
|
|
Term
| Which of the following statements is/are correct? |
|
Definition
a. A carrier frequency of 4,000 Hz is classified as a medium frequency.
b. In an electrical circuit, if voltage increases and resistance is constant, current also increases.
c. A coulomb is a measure of electrical current.
*d. a and b are correct.
e. a, b, and c are correct |
|
|
Term
| The phase charge of a symmetrical biphasic current ________________________. |
|
Definition
a. can be increased by increasing pulse duration
b. can be increased by increasing amplitude
c. is unchanged when frequency is altered
d. a and b are correct
*e. a, b, and c are correct |
|
|
Term
| A/An ________________ is a measure of resistance to the flow of electrical current. |
|
Definition
a. ampere
*b. ohm
c. volt
d. farad |
|
|
Term
| a comparison of A-beta and A-delta afferent nerve fibers, which of the following is/are true? |
|
Definition
a. Rheobase of A-delta fibers is greater.
b. At the same amplitude, the phase duration required to depolarize an A-delta fiber is longer.
c. Chronaxie of A-beta fiber is shorter.
d. a and b are correct.
*e. a, b, and c are correct. |
|
|
Term
| Electrons flow from positive to negative, which creates the electrical current. |
|
Definition
|
|
Term
| Classical Russian stimulation modulates a medium-frequency sinusoidal wave into bursts of 10 ms on and 10 ms off. |
|
Definition
|
|
Term
| When maximal contractions are needed with electrical stimulation, a 1:5 duty cycle is recommended to prevent fatigue. |
|
Definition
|
|
Term
| ________________ is the opposition to the flow of electrons by the material through which the current travels. |
|
Definition
|
|
Term
| _________________ states that voltage = current × resistance. |
|
Definition
|
|
Term
| ________________ refers to the intensity or magnitude of the current. |
|
Definition
|
|
Term
| _____________ is the time it takes to leave the isoelectric (zero) line to when it returns to the isoelectric line. |
|
Definition
|
|
Term
| ________________ is the number of pulses generated per second expressed in either pps or Hertz. |
|
Definition
|
|
Term
| . _____________ can be selected by the clinician to interrupt the current periodically for several seconds, creating an on-off time and thus allowing rest. |
|
Definition
|
|
Term
| In an electrical circuit with a fixed impedance, an increase in current is associated with _____________ in voltage. |
|
Definition
|
|
Term
| An ampere is the measure of _________; a volt is the measure of _________________; and a coulomb is the measure of ____________. |
|
Definition
| current; electrical potential or electromotive force; electrical charge |
|
|
Term
| Pulsatile currents differ from alternating and direct currents in that pulsatile currents are not _____________. |
|
Definition
|
|
Term
| ___________ is defined as the time required to depolarize a nerve fiber when the stimulus amplitude is two times rheobase. |
|
Definition
|
|
Term
Give the specific Hertz ranges for these classical categories or current frequencies:
[a] 1. Low frequency
[b] 2. Medium frequency
[c] 3. High frequency |
|
Definition
a. below 1,000 Hz
b. 1,000 to 100,000 Hz
c. greater than 100,000 Hz |
|
|
Term
| A TENS unit generating an interferential current has a 2,500-Hz carrier frequency and an 80 pulse per second treatment frequency. Why are the units of measure for carrier and treatment frequency different? |
|
Definition
| Carrier-Hz; treatment-pps. The carrier electrical current is AC, while physiologically, the treatment current is pulsatile. |
|
|
Term
| A greater phase charge is required to depolarize an A-delta fiber than to depolarize an alpha motor neuron. Why? |
|
Definition
| The A-delta fiber has a higher capacitance. |
|
|
Term
| An ice pack is an example of which form of thermal energy transfer? |
|
Definition
*a. conduction
b. convection
c. radiation
d. conversion |
|
|
Term
| A warm whirlpool is an example of which form of thermal energy transfer? |
|
Definition
a. conduction
*b. convection
c. radiation
d. conversion |
|
|
Term
| An infrared heat lamp is an example of which form of thermal energy transfer? |
|
Definition
a. conduction
b. convection
*c. radiation
d. conversion |
|
|
Term
|
Definition
a. do not conform well to the skin
b. can result in frostbite due to colder temperatures
c. do not require a layer between the pack and the skin
*d. a and b are correct
e. all of the above are true |
|
|
Term
| For contrast therapy, all of the following ratios of cooling time to rewarming time are acceptable EXCEPT |
|
Definition
a. 1:1
b. 1:2
c. 1:3
d. none of the above
*e. all of the above |
|
|
Term
| All of the following are true about cryokinetics EXCEPT |
|
Definition
a. not used on acute injuries
b. can speed functional recovery
c. alternates cold with controlled exercise
d. can break the pain–spasm cycle
*e. all of the above are true |
|
|
Term
| All of the following pertain to Raynaud’s phenomenon EXCEPT |
|
Definition
a. vasospastic disorder
*b. occurs anywhere in the body
c. constriction of arteries and arterioles
d. most common in women
e. a and b are correct |
|
|
Term
| All of the following are special precautions to be considered when using cryotherapy EXCEPT |
|
Definition
a. individuals suffering from significant medical problems
b. frail individuals
c. slow-healing wounds
*d. very young individuals
e. individuals with diminished circulation or sensation |
|
|
Term
| All of the following are physiological responses in superficial tissues to superficial heat EXCEPT |
|
Definition
*a. increased viscosity
b. increased circulation and sweating
c. increased inflammation and metabolic activity
d. increased tissue elasticity
e. all of the above are correct |
|
|
Term
| All of the following are true about the use of counterirritants EXCEPT |
|
Definition
a. results in sensation of heating
b. causes no clinically meaningful changes in temperature
c. possibly induces gate control theory of pain modulation
*d. can substitute for other modalities especially if time is an issue
e. all of the above are correct |
|
|
Term
| Of the following, which is/are true regarding cryotherapy? |
|
Definition
a. Cold depresses the inflammatory response
b. A 20-min cold application relieves pain by slowing nerve conduction velocity in nociceptive pathways.
c. Cold alleviates muscle spasm by reducing activity of muscle spindles.
d. a and b are correct.
*e. b and c are correct. |
|
|
Term
| Which alters tissue temperature 2 cm below the skin surface? |
|
Definition
a. 20-min application of superficial heat
*b. 20-min application of ice bag
c. neither a nor b
d. both a and b |
|
|
Term
| Which results in decreased muscle spindle activity? |
|
Definition
a. 20-min application of superficial heat
b. 20-min application of ice bag
c. neither a nor b
*d. both a and b |
|
|
Term
| Of the following, which is/are true regarding cold application? |
|
Definition
a. If crushed ice is placed in a plastic bag and applied to the skin, a moist towel should be placed between the bag and skin to prevent frostbite.
b. A 20-min application of cold is effective in reducing swelling because of cold-induced vasodilation.
c. Deep tissue temperature (2-3 cm) will return to baseline within minutes following a 20-min application of crushed ice.
*d. None of the statements are true.
e. a, b, and c are correct. |
|
|
Term
| Of the following, which is a correct statement regarding the response to superficial heat? |
|
Definition
*a. Heat decreases muscle spasm via a spinal reflex mechanism.
b. Heat-induced vasodilation occurs in muscle tissue following 20 min of application.
c. The analgesic response to a 20-min superficial heat application is most likely due to a decrease in nerve conduction velocity.
d. Superficial heat stimulates lymphatic drainage, which results in decreases in interstitial edema. |
|
|
Term
| An athlete presents five days following a second-degree hamstring strain. The athlete has some pain with activity and demonstrates a loss of hamstring flexibility. The athlete performs an ice massage over the injured hamstring and four long, slow hamstring stretches. The athlete stretches much farther than before applying the ice. What is the best explanation for this observation? |
|
Definition
a. Cold-induced vasodilation has increased the connective tissue temperature, making it more elastic.
*b. Cold has decreased the muscle spindle hypersensitivity, allowing the muscle to be stretched without a reflexive muscle spasm.
c. Cold has anesthetized the tissue, preventing the athlete from sensing pain during stretching.
d. Cold has activated the gate control and is blocking the sensation of pain during stretching. |
|
|
Term
| Superficial heat________________________. |
|
Definition
a. causes the release of kallikrein from sweat glands
b. promotes vasodilation in cutaneous tissue
c. increases viscosity of synovial fluid
*d. a and b are correct
e. a, b, and c are correct |
|
|
Term
| Warm whirlpools ________________________. |
|
Definition
a. heat tissues via convection
b. permit therapeutic exercise during the heat application
c. pose a risk of contamination and infection if the patient has an open wound
d. a and b are correct
*e. a, b, and c are correct |
|
|
Term
| Paraffin ______________________. |
|
Definition
a. consists of wax and mineral oil
b. should be heated to approximately 125° F
c. is contraindicated if the patient has an open wound
d. a and b are correct
*e. a, b, and c are correct |
|
|
Term
| Numbness in the volar aspect of the fourth and fifth fingers following the application of ice to the elbow is consistent with which of the following? |
|
Definition
a. cold-induced radial nerve palsy
*b. cold-induced ulnar nerve palsy
c. cold-induced median nerve palsy
d. cold urticaria |
|
|
Term
| Fluidotherapy units ____________________. |
|
Definition
a. heat tissues via convection
b. permit therapeutic exercise during the heat application
c. pose a greater risk of contamination and infection than a whirlpool or paraffin bath if the patient has an open wound
*d. a and b are correct
e. a, b, and c are correct |
|
|
Term
| The height of an infrared heating lamp is lowered from 20 to 10 in. above the skin. At a fixed treatment time, what will be the impact on tissue heating? |
|
Definition
a. It will increase 200%.
b. It will decrease 50%.
*c. It will increase 400%.
d. It will decrease 75%. |
|
|
Term
| Which of the following would be the best treatment choice for the following patient problem? The athlete is a 45-year-old tennis player who underwent ORIF for a displaced fracture of the proximal phalanx of the index finger eight weeks ago. The pin fixation was recently removed. The primary complaint is lack of motion in the M-P and PIP joints. |
|
Definition
a. hot pack
b. contrast bath
c. paraffin
*d. fluidotherapy
e. cryokinetics |
|
|
Term
| Which of the following would be the best treatment choice for the following patient problem? The athlete is a 20-year-old volleyball player who suffered a first-degree lateral ankle sprain two days ago. The team is participating in the NCAA regional tournament in two days. The team physician will allow the athlete to play, but the athlete limps while walking and has not jogged or jumped since the injury. There is some swelling but it does not limit motion. |
|
Definition
a. hot hydrocollator
b. contrast bath
c. paraffin
d. fluidotherapy
*e. cryokinetics |
|
|
Term
| To optimize the heating under an infrared lamp, the cosine law dictates that the lamp be positioned so that the angle between the heated surface and the light is 90°. |
|
Definition
|
|
Term
| Ice massage is an excellent way to reduce pain prior to therapeutic exercise. |
|
Definition
|
|
Term
| Larger temperature decreases are seen in muscles than in joints following cryotherapy. |
|
Definition
|
|
Term
| Superficial vasoconstriction occurs primarily through reflex mechanisms while decreased metabolic activity is responsible for decreased blood flow in deeper tissues. |
|
Definition
|
|
Term
| Based on the randomized controlled trials in the literature, cryotherapy has a dramatic effect on expediting the recovery from injury. |
|
Definition
|
|
Term
| Based on the randomized controlled trials in the literature, superficial heat has a dramatic effect on expediting the recovery from injury. |
|
Definition
|
|
Term
| The primary theory supporting the use of contrast therapy is cycles of vasodilatation and vasoconstriction that create a pumping action to decrease swelling. |
|
Definition
|
|
Term
| During the acute inflammatory response, use of an ice pack should be combined with __________________. |
|
Definition
| compression, elevation, protection |
|
|
Term
| _________________are the primary risk of superficial heating. |
|
Definition
|
|
Term
| The two most common sites of cold-induced nerve palsy resulting in motor loss are the ___________ and ______________ nerves. |
|
Definition
|
|
Term
| As it relates to cold water immersion, describe the concept of the thermopane. |
|
Definition
| the boundary layer of water around the body part that is warmer than the cold water |
|
|
Term
| List the progression of sensations felt during cold application. |
|
Definition
| intense cold, aching pain, pins and needles or warmth, numbness |
|
|
Term
| By what mechanisms does cryotherapy decrease muscle spasms? |
|
Definition
| decreases pain and muscle spindle activity |
|
|
Term
| List all of the precautions that need to be considered for a warm whirlpool treatment. |
|
Definition
| Temperature should not exceed 115°; watch for development of hyperthermia or heat illness; use greater caution if area not well ventilated; maintain supervision; whirlpool should be cleaned and thoroughly disinfected; no open wounds unless absolutely necessary. |
|
|
Term
| List the factors to be considered when deciding when to use cold, heat, or contrast therapy. |
|
Definition
| acuteness of injury, contraindications, severity of pain, muscle spasm, patient preference, compliance, ease of application |
|
|
Term
| List and define four absolute contraindications for the application of cold. |
|
Definition
| cold urticaria; Raynaud's phenomenon; cryoglobinemia; paroxysmal cold hemoglobinuria |
|
|
Term
| All of the following are examples of TENS units EXCEPT |
|
Definition
a. portable TENS units
*b. iontophoresis
c. biphasic low-voltage stimulators
d. interferential units
e. high-voltage stimulators |
|
|
Term
| All of the following are correct about sensory TENS (high-rate TENS) EXCEPT |
|
Definition
a. typically avoids muscle contraction
b. taps into the spinal gate mechanism of pain modulation
c. patient should feel a tingling sensation
d. primarily used in the acute phase of injury
*e. all of the above are correct |
|
|
Term
| All of the following are correct parameters pertaining to sensory TENS (high-rate TENS) EXCEPT |
|
Definition
a. high phase duration in the range of 250-300 s
*b. phase duration is high at 300 µs
c. patient should feel strong sensory perception
d. no duty cycle
e. all of the above are correct |
|
|
Term
| All of the following are potential electrode placement sites for portable TENS units EXCEPT |
|
Definition
a. trigger points
b. spinal nerve root levels
*c. deep point of the nerve supplying a painful area
d. around painful joint
e. all of the above are correct |
|
|
Term
| All of the following are correct regarding the sweep frequency of IFC EXCEPT |
|
Definition
a. the frequency of one of the carrier currents constantly changes while the other remains constant
b. provides a more effective treatment
c. reduces accommodation
d. a and b are correct
*e. all of the above are correct |
|
|
Term
| All of the following are reasons to use high-voltage stimulation EXCEPT |
|
Definition
a. edema reduction
b. pain control
c. tissue healing
*d. physiochemical responses and ion migration
e. reduction of muscle spasm |
|
|
Term
| All of the following parameters are correct for NMES EXCEPT |
|
Definition
a. high phase duration in the range of 250-300 µs
*b. high frequencies in the range of 100 pps
c. duty cycle of 1:5
d. intensity should be a strong, visible contraction
e. all of the above are correct |
|
|
Term
| All of the following are correct about galvanic current EXCEPT |
|
Definition
a. at least a 1-sec phase duration
b. one electrode is always positive and one is always negative
c. creates a physiochemical effect by changing the pH under the electrodes
d. a and c are correct
*e. all of the above are correct |
|
|
Term
| All of the following are physiochemical effects that can occur under the positive electrode during a galvanic stimulation treatment EXCEPT |
|
Definition
a. hardens tissue
b. attracts acids
c. sedative
*d. increases hemorrhage
e. contracts tissues |
|
|
Term
| All of the following are physiochemical effects that can occur under the negative electrode during a galvanic stimulation treatment EXCEPT |
|
Definition
a. dilates tissue
*b. repels alkali
c. increases congestion
d. scars are soft and pliable
e. stimulating |
|
|
Term
| What is the dosage for an iontophoretic treatment if a patient can tolerate a 4-mA peak current for 20 min? |
|
Definition
*a. 80 mA/min
b. 5 mA/min
c. 75 mA/min
d. 85 mA/min
e. all are incorrect |
|
|
Term
| All of the following are correct regarding microcurrent EXCEPT |
|
Definition
a. low-intensity stimulators
b. does not result in nerve depolarization
c. amplitude is in the microamperage range
*d. used for strong muscle contraction benefits
e. used for wound healing |
|
|
Term
| Two days following a sprain of the fibular collateral ligament, an athlete reports the loss of ability to pull her foot up. Physical examination reveals a loss of active dorsiflexion and eversion. An application of TENS with Russian current fails to elicit a contraction of the muscles of the anterior and lateral compartments. Which of the following is/are true? |
|
Definition
a. There is a concomitant injury to the common peroneal nerve.
b. TENS is ineffective in eliciting a contraction because the lower motor neuron has been injured.
c. The loss of motor control is permanent because the body cannot repair lower motor neuron damage.
*d. a and b are correct.
e. a, b, and c are correct. |
|
|
Term
| A TENS unit generating an interferential current has a 2,500-Hz carrier frequency and an 80 pulse per second treatment frequency. When the athletic trainer adjusts the treatment frequency from 80 to 100 pulses per second, ______________________. |
|
Definition
a. the carrier frequency is changed
*b. the frequency of the interfering wave is changed
c. the phase duration of the stimulating current is changed
d. b and c are correct
e. a, b, and c are correct |
|
|
Term
| All of the following are examples of TENS units EXCEPT |
|
Definition
a. portable TENS units
*b. iontophoresis
c. biphasic low-voltage stimulators
d. interferential units
e. high-voltage stimulators |
|
|
Term
| All of the following are correct about sensory TENS (high-rate TENS) EXCEPT |
|
Definition
a. typically avoids muscle contraction
b. taps into the spinal gate mechanism of pain modulation
c. patient should feel a tingling sensation
d. primarily used in the acute phase of injury
*e. all of the above are correct |
|
|
Term
| All of the following are correct parameters pertaining to sensory TENS (high-rate TENS) EXCEPT |
|
Definition
a. high phase duration in the range of 250-300 s
*b. phase duration is high at 300 µs
c. patient should feel strong sensory perception
d. no duty cycle
e. all of the above are correct |
|
|
Term
| All of the following are potential electrode placement sites for portable TENS units EXCEPT |
|
Definition
a. trigger points
b. spinal nerve root levels
*c. deep point of the nerve supplying a painful area
d. around painful joint
e. all of the above are correct |
|
|
Term
| All of the following are correct regarding the sweep frequency of IFC EXCEPT |
|
Definition
a. the frequency of one of the carrier currents constantly changes while the other remains constant
b. provides a more effective treatment
c. reduces accommodation
d. a and b are correct
*e. all of the above are correct |
|
|
Term
| All of the following are reasons to use high-voltage stimulation EXCEPT |
|
Definition
a. edema reduction
b. pain control
c. tissue healing
*d. physiochemical responses and ion migration
e. reduction of muscle spasm |
|
|
Term
| All of the following parameters are correct for NMES EXCEPT |
|
Definition
a. high phase duration in the range of 250-300 µs
*b. high frequencies in the range of 100 pps
c. duty cycle of 1:5
d. intensity should be a strong, visible contraction
e. all of the above are correct |
|
|
Term
| All of the following are correct about galvanic current EXCEPT |
|
Definition
a. at least a 1-sec phase duration
b. one electrode is always positive and one is always negative
c. creates a physiochemical effect by changing the pH under the electrodes
d. a and c are correct
*e. all of the above are correct |
|
|
Term
| All of the following are physiochemical effects that can occur under the positive electrode during a galvanic stimulation treatment EXCEPT |
|
Definition
a. hardens tissue
b. attracts acids
c. sedative
*d. increases hemorrhage
e. contracts tissues |
|
|
Term
| All of the following are physiochemical effects that can occur under the negative electrode during a galvanic stimulation treatment EXCEPT |
|
Definition
a. dilates tissue
*b. repels alkali
c. increases congestion
d. scars are soft and pliable
e. stimulating |
|
|
Term
| What is the dosage for an iontophoretic treatment if a patient can tolerate a 4-mA peak current for 20 min? |
|
Definition
*a. 80 mA/min
b. 5 mA/min
c. 75 mA/min
d. 85 mA/min
e. all are incorrect |
|
|
Term
| All of the following are correct regarding microcurrent EXCEPT |
|
Definition
a. low-intensity stimulators
b. does not result in nerve depolarization
c. amplitude is in the microamperage range
*d. used for strong muscle contraction benefits
e. used for wound healing |
|
|
Term
| Two days following a sprain of the fibular collateral ligament, an athlete reports the loss of ability to pull her foot up. Physical examination reveals a loss of active dorsiflexion and eversion. An application of TENS with Russian current fails to elicit a contraction of the muscles of the anterior and lateral compartments. Which of the following is/are true? |
|
Definition
a. There is a concomitant injury to the common peroneal nerve.
b. TENS is ineffective in eliciting a contraction because the lower motor neuron has been injured.
c. The loss of motor control is permanent because the body cannot repair lower motor neuron damage.
*d. a and b are correct.
e. a, b, and c are correct. |
|
|
Term
| A TENS unit generating an interferential current has a 2,500-Hz carrier frequency and an 80 pulse per second treatment frequency. When the athletic trainer adjusts the treatment frequency from 80 to 100 pulses per second, ______________________. |
|
Definition
a. the carrier frequency is changed
*b. the frequency of the interfering wave is changed
c. the phase duration of the stimulating current is changed
d. b and c are correct
e. a, b, and c are correct |
|
|
Term
| Of the following, which is/are true regarding neuromuscular stimulation? |
|
Definition
a. A larger phase charge is associated with the depolarization of more motor units.
b. A ramp time of 3-5 sec decreases the risk of injury to the muscle and other soft tissues.
c. A duty cycle should be selected that will allow the muscle to recover between contractions.
d. a and b are correct.
*e. a, b, and c are correct. |
|
|
Term
| A duty cycle is needed for neuromuscular stimulation to allow restoration of ____________________. |
|
Definition
*a. ATP levels in the muscle
b. acetylcholine levels in the neuromuscular junction
c. ATP in the motor neuron
d. b and c are correct
e. a, b, and c are correct |
|
|
Term
| Placement of TENS electrodes over the carotid sinuses is contraindicated because __________________________. |
|
Definition
a. the current may result in vasoconstriction and a decrease in blood flow to the brain
*b. the current may cause stimulation of the baroreceptors and alter the regulation of blood pressure and pulse
c. the stimulation may result in ischemic pain in the sternocleidomastoid muscle
d. the electrical current may result in ion flux and affect electrolyte regulation |
|
|
Term
| Of the following, which will result in an increase in force generated by a muscle during neuromuscular stimulation? |
|
Definition
a. increasing the phase duration while maintaining the amplitude
b. increasing the frequency from 5 to 50 pps
c. increasing the ramp time from 3 to 5 sec
*d. a and b are correct
e. a, b, and c are correct |
|
|
Term
| Motor TENS is contraindicated when the muscle contractions could exacerbate the acute inflammatory response. |
|
Definition
|
|
Term
| Many portable TENS units allow the clinician to use a modulation mode to decrease accommodation to the stimulation. |
|
Definition
|
|
Term
| When setting up an IFC treatment for pain control, a duty cycle of 1:3 is suggested. |
|
Definition
|
|
Term
| During a high-voltage stimulation treatment, if the distance between the electrodes is increased, there is potentially a deeper penetration of the current. |
|
Definition
|
|
Term
| It is likely that a regimen of NMES treatments can significantly increase the strength of a healthy muscle. |
|
Definition
|
|
Term
| Generally, a 1:5 "on" to "off" time is required during a NMES treatment to allow enough time for the muscle to regenerate its local energy utilized for contraction; otherwise fatigue will develop quickly. |
|
Definition
|
|
Term
| Alpha motor neurons can regenerate and active control of the muscle can be restored through various forms of electrical stimulation. |
|
Definition
|
|
Term
| The only effective treatment of microcurrent is for slow-healing skin lesions, and certified athletic trainers are not prepared to treat these conditions. |
|
Definition
|
|
Term
| A football player sustained a brachial plexus "burner" five days ago. He is having difficulty contracting the deltoid and abducting the glenohumeral joint. A Russian stimulator is used in an effort to facilitate deltoid contraction. The Russian current fails to produce a contraction. The athletic trainer concludes that the athlete has sustained a _______ motor neuron lesion involving the __________ nerve. |
|
Definition
|
|
Term
| A beat frequency of _______________ is used for sensory TENS, a beat frequency of ___________ for muscle contraction, and a beat frequency of ________________ for motor TENS. |
|
Definition
| 60-100 bps, 50-60 bps, 2-4 bps |
|
|
Term
| ___________________ is the process in which ions in solution are transferred through the skin via electrical potential. |
|
Definition
|
|
Term
| Hydrocortisone is used during an iontophoretic treatment for pain and inflammation and has a _____________ polarity, while acetic acid is used for calcium deposits and has a _________ polarity. |
|
Definition
|
|
Term
| When the nerve to a muscle is not functioning, the muscle is said to be ______________. |
|
Definition
|
|
Term
| ______________ is a form of electrotherapy in which the stimulus amplitude is in the microamperage range. |
|
Definition
|
|
Term
| List the many clinical uses of electrical stimulation. |
|
Definition
pain
muscle stimulation through alpha motor nerve
stimulation of denervated muscle iontophoresis
edema reduction
wound healing |
|
|
Term
| What are the two distinct specifications that high-voltage stimulators must have? |
|
Definition
| transmit a voltage of at least 150 volts and use a twin-peaked monophasic current |
|
|
Term
| Describe the premise of using NMES for muscle reeducation purposes. |
|
Definition
| overcome arthrogenic muscle inhibition following injury by retraining the neuromuscular component |
|
|
Term
| An athletic trainer applies TENS to the shoulder of an athlete with a Grade II acromioclavicular separation. The stimulus produces a tingling sensation without causing a muscle contraction. The team physician inquires as to why the TENS unit is being applied. The athletic trainer responds that the TENS is being applied to reduce pain. What further explanation could the athletic trainer provide regarding how the TENS can reduce the athlete's pain? |
|
Definition
| explain gate control theory of pain modulation or Level I model |
|
|
Term
| With interferential current, if the carrier frequency of 5,000 Hz produces phase durations of 100 µs, what would be the phase duration if the carrier frequency were 2,500 Hz? |
|
Definition
|
|
Term
| When one is applying TENS for neuromuscular stimulation of the quadriceps muscles, an increase in phase charge will tend to increase the force generated by the muscle. Why? |
|
Definition
| The greater phase charge results in stimulation of more motor units. Because more motor units-and therefore muscle fibers-are being recruited, more force is generated by the muscle. |
|
|
Term
| All of the following are correct with regard to the ERA of ultrasound EXCEPT |
|
Definition
a. it is smaller than the surface area of the sound head
b. it is the area that receives at least 5% of the peak sound energy
c. it is characterized by an area of high and low intensity
d. ERA stands for effective radiating area
*e. all of the above are correct |
|
|
Term
| All of the following are correct regarding the BNR of ultrasound EXCEPT |
|
Definition
a. the ratio between the peak intensity of the US beam divided by the average intensity of the US beam across the ERA
b. low BNR reduces the risk of hot spots
c. acceptable range is 2-6
*d. BNR stands for Boi nonuniformity ratio
e. all of the above are correct |
|
|
Term
| All of the following are correct regarding the conducting media for ultrasound EXCEPT |
|
Definition
a. amount of sound energy conducted varies greatly between different media
b. medium is needed because sound beams cannot travel through the air
c. US gel and gel pads are superior to other conducting media
*d. water is a good but not a great conducting medium
e. all of the above are correct |
|
|
Term
| All of the following are clinician-controlled the parameters for ultrasound EXCEPT |
|
Definition
*a. BNR
b. frequency
c. amplitude
d. duty cycle
e. duration of treatment |
|
|
Term
| All of the following affect the amount of acoustical energy from US that is absorbed in the tissues EXCEPT |
|
Definition
a. frequency
b. characteristics of the tissues
c. dose and duty cycle
d. duration of the treatment
*e. all of the above will affect absorption |
|
|
Term
| All of the following are correct regarding the types of tissues that can be affected by US EXCEPT |
|
Definition
*a. tissues with high protein and water content have higher absorption rates
b. tendon, ligament, and muscle absorb US energy fairly well
c. superficial bones and nerves absorb the most energy
d. adipose tissue and skin do not absorb US energy very well
e. all of the above are correct |
|
|
Term
| All of the following are true regarding the cooling of tissues following the application of US EXCEPT |
|
Definition
a. tissue temperature falls fairly rapidly following US treatment
b. effects of US are short-lived
c. superficial tissues cool more rapidly than deeper tissues
d. stretching and manual therapies should occur immediately following US treatment
*e. all of the above are correct |
|
|
Term
| All of the following are true regarding acoustical streaming from the application of US EXCEPT |
|
Definition
a. a nonthermal effect
b. due to mechanical pressure exerted by the sound waves
c. facilitates fluid movement and increases cell permeability
*d. causes gas bubbles to expand and contract
e. none of the above are correct |
|
|
Term
| All of the following are true regarding cavitation from the application of US EXCEPT |
|
Definition
a. a nonthermal effect
b. formation of gas bubbles
c. unstable cavitation refers to the collapse of these bubbles and can cause tissue damage
*d. most associated with high-frequency, low-intensity sound waves
e. stable cavitation facilitates fluid movement and membrane transport |
|
|
Term
| All of the following are true regarding contraindications for US EXCEPT |
|
Definition
*a. over metal implants
b. cancer, malignancies, and tumors
c. near the abdomen of a pregnant woman or with women who could be pregnant
d. near the heart or cardiac pacemaker
e. over open epiphyses |
|
|
Term
| All of the following are true regarding phonophoresis EXCEPT |
|
Definition
a. similar to iontophoresis in that it drives medications through the skin
*b. significant research proves its effectiveness
c. must mix the active medication with a good conducting gel
d. several medications can be used like hydrocortisone, ketoprofen
e. is noninvasive and spares the patient the fear of injections |
|
|
Term
| All of the following are correct about the capacitance method of delivering short-wave diathermy EXCEPT |
|
Definition
a. heating occurs rapidly around the dipoles
*b. body is not placed in the electric field
c. as the dipoles rotate, they cause mechanical friction that results in local heating
d. very good for heating subcutaneous fat rather than deeper tissues
e. not ideal for musculoskeletal injuries |
|
|
Term
| All of the following are correct about the inductance method of delivering short-wave diathermy EXCEPT |
|
Definition
a. body is not placed in the electrical field
b. uses a magnetic field
c. creates small currents in tissues like muscle
*d. greatest heating occurs in tissue with high impedance
e. great for heating deeper tissues |
|
|
Term
| Of the following, which are correct about short-wave diathermy? |
|
Definition
a. uses a frequency of 27.12 MHz
b. effective for deep heating of large areas
c. machines can be expensive
d. parameters for safe use over metal implants have not been established
*e. all of the above are correct |
|
|
Term
| Ultrasound pulsed at a 20% duty cycle with an intensity of 1 W/cm2 results in _______________. |
|
Definition
a. transient cavitation
b. acoustical streaming
c. 5° C (or greater) increases in tissue temperature
*d. a and b are correct
e. a, b, and c are correct |
|
|
Term
| Of the following, which is/are true regarding continuous ultrasound? |
|
Definition
a. At 1 MHz, tissue temperature increases of 4° require more than a 5-min application.
b. Less application time is required for the same temperature increase with use of 3 MHz rather than 1 MHz.
c. A lower treatment frequency results in heating in deeper tissues.
d. a and b are correct.
*e. a, b, and c are correct. |
|
|
Term
| Beam nonuniformity ratio _____________________________. |
|
Definition
a. equals spatial peak intensity divided by spatial average intensity
b. should be 6 or less before a machine is used for patient care
c. is approximately equal to the surface area of the ultrasound head
*d. a and b are correct
e. a, b, and c are correct |
|
|
Term
| Phonophoresis ________________________. |
|
Definition
*a. is a treatment technique in which ultrasound is used to drive medication into subcutaneous tissue
b. is clearly the treatment of choice in the management of tendinitis
c. is best administered using pulsed ultrasound
d. a and b are correct
e. a, b, and c are correct |
|
|
Term
| Which of the following would contraindicate the use of diathermy in treating low back pain? |
|
Definition
a. presence of a Harrington rod (rod fixation of a lateral spinal curve)
b. pregnancy
c. cardiac pacemaker
d. a and b are correct
*e. a, b, and c are correct |
|
|
Term
| Of the following, which is/are true regarding the application of pulsed ultrasound |
|
Definition
a. Changing the duty cycle from 10% to 20% will result in heating of deeper tissues.
b. A higher intensity results in deeper heating of tissues.
*c. Adipose tissue absorbs little sound energy.
d. a and b are correct.
e. a, b, and c are correct. |
|
|
Term
| Of the following, which would contraindicate the application of therapeutic ultrasound? |
|
Definition
a. malignant tissue
b. thrombophlebitis
c. presence of a surgical pin
*d. a and b are correct
e. a, b, and c are correct |
|
|
Term
| Of the following, which is/are true regarding the application of therapeutic ultrasound? |
|
Definition
a. At 3-MHz frequency, 4-5 min of application is necessary to heat tissue 4-5° C.
b. A longer treatment time should be used with lower frequencies of ultrasound.
c. The area treated should be no greater than three to four times the ERA.
d. a and b are correct.
*e. a, b, and c are correct. |
|
|
Term
| Diathermy differs from ultrasound in which of the following ways? |
|
Definition
*a. the classification (electromagnetic, mechanical, acoustic, light) of the energy delivered to the tissue
b. the energy transfer mechanism that results in tissue heating
c. both a and b are correct
d. neither a nor b is correct |
|
|
Term
| Which of the following is/are true? |
|
Definition
a. An ultrasound unit with a BNR of 4:1 set at an intensity of 1.2 W/cm2 produces a spatial peak intensity of 4.8 W/cm2.
b. Ultrasound will result in greater heating in tendon than in muscle because tendon has a greater amount of protein.
c. Diathermy through the inductance technique results in greater heating in muscle than the capacitance technique does.
*d. a and b are correct.
e. a, b, and c are correct |
|
|
Term
| Given the following information about an ultrasound unit and the parameter settings, calculate the spatial peak intensity: BNR = 2.1, Tx area = 15 cm2, power = 6 W, frequency = 1 MHz, duty cycle = 100%, spatial average intensity = 1.5 W/cm2. |
|
Definition
a. 0.75 W/cm2
b. 1.5 W/cm2
*c. 3 W/cm2
d. 6 W/cm2 |
|
|
Term
| The primary determinant of the depth of heating with therapeutic ultrasound is _______________. |
|
Definition
*a. frequency
b. duty cycle
c. intensity
d. effective radiating area |
|
|
Term
| Responses to pulsed ultrasound are believed to be due to the effect of the sound energy at the cellular level rather than tissue heating. |
|
Definition
|
|
Term
| Phonophoresis has been used commonly in athletic training and physical therapy despite the scarcity of research as to its effectiveness. |
|
Definition
|
|
Term
| The sound energy used therapeutically is identical to that used for imaging fetuses and hearts. |
|
Definition
|
|
Term
| The antispasmotic and analgesic responses to ultrasound are not as good as those seen with cryotherapy and superficial heat. |
|
Definition
|
|
Term
| The primary effects of continuous ultrasound are increases in collagen tissue elasticity and increased tissue temperature. |
|
Definition
|
|
Term
| The total energy delivered with pulsed ultrasound is more than with continuous ultrasound at the same intensity and duration. |
|
Definition
|
|
Term
| Based on the current research, there is little evidence supporting the use of therapeutic ultrasound on musculoskeletal injuries. |
|
Definition
|
|
Term
| There is some promising evidence indicating that the application of ultrasound prior to stretching and manual therapies may be beneficial. |
|
Definition
|
|
Term
| The ________________ of sound energy delivered is based on the amount of energy being emitted divided by the radiating area of the crystal measured in W/cm2. |
|
Definition
|
|
Term
| When continuous ultrasound is delivered, the greater amount of energy absorbed, the ____________ amount of tissue heating. |
|
Definition
|
|
Term
| Ultrasound at higher frequencies affects tissues that are more _______________, whereas at a lower frequency less energy is absorbed _______________ and more is allowed to penetrate into deeper tissues. |
|
Definition
| superficial, superficially |
|
|
Term
| According to the literature, the nonthermal effects of ultrasound are attributed to _______________ and ____________________. |
|
Definition
| acoustical streaming, stable cavitation |
|
|
Term
| _____________________ is the movement of fluids along the cell membranes due to the pressure exerted by the sound waves. |
|
Definition
|
|
Term
| _____________________ is the formation of gas-filled bubbles. |
|
Definition
|
|
Term
| _____________________ is the therapeutic generation of local heating by high-frequency electromagnetic waves. |
|
Definition
|
|
Term
| Describe the research on the level of heating needed to have a positive impact on metabolic activity, muscle spasm, blood flow, and viscoelastic properties of collagen. |
|
Definition
| increase 1° C = increase metabolic activity; increase 2-3° C = increase BF, reduce muscle spasm; increase 4° C = increase viscoelastic properties of collagen |
|
|
Term
| Identify the parameters you would set for ultrasound treatment for each of the following: (1) heat a piriformis muscle; (2) increase blood flow in the patella tendon. |
|
Definition
| (1) 1 MHz, continuous, 1.5-2.0 W/cm2, 8-10 min; (2) 3 MHz, continuous, 1.5-2.0 W/cm2, 4-5 min |
|
|
Term
| All of the following are specific categories of lasers based on the way they are made EXCEPT |
|
Definition
a. semiconductor (diode)
*b. full conductor (polar)
c. liquid (dye)
d. solid (ruby)
e. gas (helium-neon) |
|
|
Term
| All of the following are parts of a laser EXCEPT |
|
Definition
*a. power pump
b. power supply (energy source)
c. lasing medium (gas, liquid)
d. resonating cavity (mirrored chamber)
e. all of the above |
|
|
Term
| All of the following are interrelated properties of all lasers EXCEPT |
|
Definition
*a. emission
b. coherence
c. monochromatic
d. collimation
e. all of the above |
|
|
Term
| Which of the following are laser hazard classifications based on safe exposure limits? |
|
Definition
a. 1
b. 2
c. 3a and 3b
d. 4
*e. all of the above |
|
|
Term
| All of the following are correct about laser hazard classifications EXCEPT |
|
Definition
*a. categories 1, 2, 3a, and 3b are considered very safe
b. category 3b has some risks
c. category 4 has serious risks
d. a and b only
e. all of the above |
|
|
Term
| All of the following are correct about class 1 lasers EXCEPT |
|
Definition
*a. they are incapable of producing damaging radiation except in the eye
b. laser printers and CD players are examples of this type of laser
c. they are exempt from most control measures
d. a and b only
e. all of the above |
|
|
Term
| All of the following are correct about class 2 lasers EXCEPT |
|
Definition
a. they emit visible radiation
b. usually they are not harmful to the eye due to natural aversion reflex
c. an example is supermarket bar code scanner
d. a and b only
*e. exempt from most control measures |
|
|
Term
| All of the following are correct about class 3b lasers EXCEPT |
|
Definition
*a. they are the highest power lasers we have
b. viewing them can be dangerous
c. they are not a fire hazard
d. most LLLT are of this class
e. all of the above |
|
|
Term
| All of the following are correct about class 4 lasers EXCEPT |
|
Definition
a. they are the highest power lasers we have
b. viewing them can be dangerous to both eye and skin
c. they are a fire hazard
*d. also used for LLLT devices
e. all of the above |
|
|
Term
| All of the following are correct about parameter selection as it relates to the patient EXCEPT |
|
Definition
a. pigmentation of the skin
*b. age and history of previous use
c. type and condition of the tissue targeted
d. acute vs. chronic
e. all of the above are considerations |
|
|
Term
| All of the following are correct about parameter selection as it relates to the laser EXCEPT |
|
Definition
a. wavelength
b. power density (intensity)
c. energy density (dosage)
d. average power and power output
*e. classification of the laser |
|
|
Term
| All of the following are correct about choosing a laser EXCEPT |
|
Definition
a. wavelength
b. depths of penetration
c. ease of application
d. power density (intensity)
*e. all of the above should be considered |
|
|
Term
| All of the following are correct about the helium-neon gas laser EXCEPT |
|
Definition
a. commonly used in superficial wound care
b. usually emits a red light
*c. does not use fiber optics
d. one of the first developed in the 1970s
e. all of the above are correct |
|
|
Term
| All of the following are correct about the gallium-arsenide laser EXCEPT |
|
Definition
*a. visible to humans
b. classified as a semiconductor laser
c. depth of penetration is 30-50 mm
d. used on deeper tissues like tendon and ligament
e. all of the above are correct |
|
|
Term
| All of the following are correct about the indium-gallium-aluminum-phosphide laser EXCEPT |
|
Definition
a. gradually replacing HeNe lasers
b. classified as a semiconductor laser
*c. requires fiber optics
d. commonly used in superficial wound care
e. all of the above are correct |
|
|
Term
| All of the following are correct about the gallium-aluminum-arsenide laser EXCEPT |
|
Definition
a. delivered in the continuous wave mode
b. classified as a semiconductor laser
*c. higher output allows for longer treatment times
d. commonly used in deeper tissues than other lasers
e. all of the above are correct |
|
|
Term
| All of the following are correct about the combination probe lasers EXCEPT |
|
Definition
a. contain several single-wavelength laser diodes in one probe
b. combine LEDs with single laser, or multiple laser diodes with single LED
c. LED allows clinician to see laser energy being applied
*d. LED and laser are both therapeutic
e. all of the above are correct |
|
|
Term
| All of the following are correct about the dosage of lasers EXCEPT |
|
Definition
. determined by the total amount of energy applied to the tissues
b. the higher the power of the laser, the shorter time to deliver the same dosage
c. also determined by the intensity of the laser and the time of application
*d. intensity = beam diameter divided by power in watts
e. most treatments delivered per square centimeter |
|
|
Term
| All of the following are correct about the output power of lasers EXCEPT |
|
Definition
a. measured in watts (W) or milliwatts (mW)
*b. is adjustable by the clinician
c. important to categorize the laser for safety purposes
d. a and c are correct
e. all of the above are correct |
|
|
Term
| All of the following are correct about the treatment frequency of lasers EXCEPT |
|
Definition
a. acute conditions are treated more frequently than chronic ones
b. least amount of energy brings about the best results
*c. physiological responses to treatment are consistent between individuals
d. laser has a cumulative effect, so small doses spaced farther apart have better outcomes
e. treatments three to four times per week with moderate doses is better than higher doses fewer times per week |
|
|
Term
| All of the following are correct about the point application technique of laser EXCEPT |
|
Definition
a. used when treating trigger points; laser placed directly over the point and dosage is delivered
b. cosine and inverse square laws apply
*c. the laser should not touch the skin
d. can be applied with either the scanning or grid technique
e. all of the above are correct |
|
|
Term
| All of the following have been reported as physiological effects of LLLT EXCEPT |
|
Definition
a. decreased pain
b. expedited inflammatory process
c. promoted tissue healing
*d. reduced swelling
e. all of the above are correct |
|
|
Term
| All of the following are correct regarding eye safety and LLLT EXCEPT |
|
Definition
a. never look into the aperture of the laser
b. retina damage can occur if necessary precautions are not observed
c. wear eye protection at all times
d. follow laser operator's manual warning signs
*e. the eye's protective reflex will prevent damage |
|
|
Term
| Lasers are the most refined form of light energy and are now used extensively for medical and scientific reasons. |
|
Definition
|
|
Term
| The FDA, in 2002, approved the LLLT for only specific conditions involving the shoulder, neck, and wrist. |
|
Definition
|
|
Term
| Now that LLLT is approved by the FDA, clinicians can bill for any application they feel would benefit from its use. |
|
Definition
|
|
Term
| LLLT and LED should not be confused even though the terms are often used interchangeably. |
|
Definition
|
|
Term
| Parameter selection is a very easy aspect of LLLT since there are so few variables to consider. |
|
Definition
|
|
Term
| Many of the LLLT devices available are menu driven, so when you select the tissue type and chronicity of the injury, the dosage is calculated and provided for you. |
|
Definition
|
|
Term
| A basic tenet of electromagnetic energy is that the longer the wavelength is, the greater the depth of penetration. |
|
Definition
|
|
Term
| Laser energy can be applied in a pulse-train or continuous-frequency mode depending on the desired effects. |
|
Definition
|
|
Term
| The recommended dosage for wounds with intact skin is .5-1 J/cm2 and for open wounds is 2-4 J/cm2. |
|
Definition
|
|
Term
| The proposed mechanism of action of LLLT is the ability of the cell to absorb the photon and transform the energy into ADP. |
|
Definition
|
|
Term
| Acute injuries can be treated more frequently (daily) than chronic wounds (two to three times per week) because chronic wounds do not respond well to aggressive therapy. |
|
Definition
|
|
Term
| Other modalities used in conjunction with LLLT can be beneficial, although thermal applications should be done before the laser treatment. |
|
Definition
|
|
Term
| LASER is an acronym for _________________________. |
|
Definition
| light amplification of stimulated emission |
|
|
Term
| _________________ means that the light is of one color only or of one wavelength that is specific to the energy level of the photon. |
|
Definition
|
|
Term
| _________________ means that all of the waves of light energy are of the same length and are traveling in a similar phase relationship. |
|
Definition
|
|
Term
| _________________ means the degree to which the beam remains parallel with distance. |
|
Definition
|
|
Term
| ___________________ or ___________________ are the light-absorbing components of cells. |
|
Definition
| Chromophores, photoacceptors |
|
|
Term
| _____________________ means that laser radiation can stimulate or inhibit cells so as to be beneficial or destructive. |
|
Definition
|
|
Term
| What is the formula for power density? |
|
Definition
| PD = intensity = power in W/beam diameter in cm = W/cm2 |
|
|
Term
| Explain the Arndt-Shultz principle. |
|
Definition
| It suggests that some energy may elicit a small response in biological tissues, either beneficial or destructive. |
|
|
Term
| All of the following are initial treatment goals during the acute phase of the inflammatory response EXCEPT |
|
Definition
a. limit secondary cell death
b. protect damaged tissues
c. control swelling
d. reduce pain and loss of function
*e. all of the above are correct |
|
|
Term
| All of the following pertain to RICE EXCEPT |
|
Definition
a. most of the acute-stage goals can be accomplished through the combination of these four things
b. elevation plays a bigger role in the reduction of swelling than ice
c. felt pads, horseshoes, and donuts increase the effectiveness of the compression component
*d. only to be used for a few hours following the injury
e. all of the above are correct |
|
|
Term
| All of the following modalities can be used in conjunction with RICE EXCEPT |
|
Definition
a. TENS
b. therapeutic exercise in the pain-free range
c. microcurrent
*d. ultrasound
e. all of the above may be used |
|
|
Term
| All of the following are treatment goals during the repair phase of the inflammatory response EXCEPT |
|
Definition
*a. limiting secondary cell death
b. eventual increase in strength and endurance
c. restoring ROM
d. restoring neuromuscular control
e. all of the above are correct |
|
|
Term
| All of the following are options when your patient has a normal gait while walking but develops a limp while jogging EXCEPT |
|
Definition
a. continue exercise if instructional or visual feedback corrects the limp
b. continue exercise if cold will allow pain-free activity
c. limit the patient to exercises that are pain free
d. terminate the exercise session
*e. continue at all costs so the patient can get back ASAP |
|
|
Term
| All of the following are true with regard to the maturation phase of the inflammatory response EXCEPT |
|
Definition
a. pain control no longer needed
b. a functional progression back to practice and competition should be implemented
c. there is little need for many therapeutic modalities
d. the level of therapeutic exercise can be progressed to patient tolerance
*e. all of the above are correct |
|
|
Term
| All of the following are true with regard to the maturation phase of the inflammatory response EXCEPT |
|
Definition
a. patient will experience pain after, but not during, exercise
b. tensile strength increases due to realignment of collagen
*c. a relatively short phase compared to the first two phases
d. tissues respond to the stresses placed upon them
e. all of the above are correct |
|
|
Term
| All of the following are possible causes of slow-to-heal and nonhealing skin lesions EXCEPT |
|
Definition
*a. poor wound dressings
b. pressure and vascular compromise
c. medical complications
d. limited mobility
e. poor nutrition |
|
|
Term
| The realignment and increased tensile strength of Type I collagen is most associated with which stage(s) of the inflammatory response? |
|
Definition
a. acute
b. tissue repair
*c. remodeling/maturation
d. a and c are correct
e. b and c are correct |
|
|
Term
| Of the following, which is/are true regarding cryotherapy? |
|
Definition
*a. A 20-min application of crushed ice will decrease nerve conduction velocity of small-diameter, primary afferent nerve fibers.
b. A 20-min application of crushed ice will decrease swelling through reflex vasodilation of the venules.
c. Cold application promotes removal of damaged tissues and tissue repair by inhibiting the inflammatory process.
d. a and b are correct.
e. a, b, and c are correct. |
|
|
Term
| Of the following, which is/are true regarding treatments that effectively limit or reduce swelling? |
|
Definition
*a. Elevation may limit swelling by reducing capillary hydrostatic pressure.
b. TENS using a monophasic current with the negative electrode placed over the swollen area is effective at reducing swelling by promoting lymphatic absorption.
c. Ice application reduces swelling secondary to cold-induced vasodilation.
d. Ultrasound prevents the development of swelling by decreasing tissue free fluid pressure. |
|
|
Term
| An athlete was injured falling from a horse five days ago. The athlete landed on the right shoulder. An evaluation revealed only a severe contusion. The athlete is suffering from muscle guarding and loss of motion in a shoulder secondary to restricted accessory motions. Active motion is painful. Which of the following manual therapies may prove beneficial in achieving pain relief and early range of motion for this athlete? |
|
Definition
a. strain-counterstrain
b. grades I and II joint mobilization
c. grade V joint mobilization
*d. a and b are correct
e. a, b, and c are correct |
|
|
Term
| A sprinter goes down clutching his left hamstring. Which of the following most likely occurs? |
|
Definition
a. Afferent input from proprioceptors decreases to the CNS, which increases gamma efferent activity to the hamstrings and causes spasm.
b. Nociceptors increase afferent input to the CNS and cause a decrease in alpha and gamma efferent flow, inhibiting hamstring function due to pain.
c. Nociceptors decrease afferent input to the CNS, which results in decreased alpha and gamma efferent stimulation of the hamstrings.
*d. Nociceptors increase afferent input to the CNS, which results in increased gamma efferent and, ultimately, alpha efferent stimulation of the hamstrings. |
|
|
Term
| Of the following, which is/are true regarding cryokinetics? |
|
Definition
*a. When administering cryokinetics, the athletic trainer must be certain that the exercise activity does not pose a risk of reinjury to healing tissues.
b. Cold water immersion, ice massage, and vapocoolant spray are acceptable forms of cold application.
c. Cold should be applied until it is perceived as uncomfortable.
d. a and b are correct.
e. a, b, and c are correct. |
|
|
Term
| Elevation of an injured ankle will quickly affect ____________________. |
|
Definition
*a. capillary hydrostatic pressure
b. capillary osmotic pressure
c. interstitial osmotic pressure
d. a and b are correct
e. a, b, and c are correct |
|
|
Term
| The body's initial response to tissue injury, mediated through epinephrine and thromboxane, begins at the moment of tissue damage. |
|
Definition
|
|
Term
| If the acute inflammatory process is not completed, tissue will not be repaired. |
|
Definition
|
|
Term
| Elevation does not have as great an impact on the acute inflammatory process as ice does. |
|
Definition
|
|
Term
| Controlling pain after motion and recovering motion and function become the central focus of the repair phase. |
|
Definition
|
|
Term
| The exercise is inappropriate if the pain experienced alters proper movement mechanics and if the injured person is unable to do tomorrow what was done today. |
|
Definition
|
|
Term
| The application of cryotherapy, as well as electrical, acoustic, and laser energies has been shown to speed wound healing through increased collagen production by fibroblasts. |
|
Definition
|
|
Term
| Identify where the following chemical mediator (1) is formed or released from, and (2) the principal physiological effect: histamine. |
|
Definition
| (1) mast cell, released through mast cell degranulation; (2) vasodilation and increase in capillary membrane permeability |
|
|
Term
| Identify where the following chemical mediator (1) is formed or released from, and (2) the principal physiological effect: proteins of the complement cascade. |
|
Definition
| (1) converted from inactive to active plasma proteins through a cascade of reactions; (2) stimulation of all aspects of the acute inflammatory process |
|
|
Term
| Identify where the following chemical mediator (1) is formed or released from, and (2) the principal physiological effect: prostaglandin E2. |
|
Definition
| (1) synthesized by mast cell; (2) pain |
|
|
Term
| Identify where the following chemical mediator (1) is formed or released from, and (2) the principal physiological effect: thromboxane. |
|
Definition
| (1) released from endothelial cells; (2) vasoconstriction |
|
|
Term
| Identify where the following chemical mediator (1) is formed or released from, and (2) the principal physiological effect: bradykinin. |
|
Definition
| (1) converted from inactive plasma protein kininogen; (2) pain |
|
|
Term
| Refer to the following responses when answering this question. Select the single best option: (1) ice pack, (2) moist heat pack, (3) cold whirlpool, (4) warm whirlpool, (5) contrast bath, (6) ultrasound at 1.0 MHz, (7) ultrasound at 3.0 MHz, (8) diathermy. To treat a female soccer player who sustained a second-degree inversion ankle sprain 10 min ago. Why would you select this treatment? |
|
Definition
| (1) ice pack. To decrease pain while elevating the injured ankle. |
|
|
Term
| Refer to the following responses when answering this question. More than one answer is rational, but select the single best option: (1) ice pack, (2) moist heat pack, (3) cold whirlpool, (4) warm whirlpool, (5) contrast bath, (6) ultrasound at 1.0 MHz, (7) ultrasound at 3.0 MHz, (8) diathermy. At two weeks, the female soccer player admits that she tried to play a pickup game of soccer over the weekend. She now presents with an increase in pain and palpatory tenderness but no significant increase in edema. She also has an antalgic gait. What treatments are appropriate? |
|
Definition
| (1) ice pack or (3) cold whirlpool for cryokinetics. |
|
|
Term
| Refer to the following responses when answering this question. More than one answer is rational, but select the single best option: (1) ice pack, (2) moist heat pack, (3) cold whirlpool, (4) warm whirlpool, (5) contrast bath, (6) ultrasound at 1.0 MHz, (7) ultrasound at 3.0 MHz, (8) diathermy. At three weeks postinjury, the female soccer player appears to be progressing well. She no longer has an antalgic gait but does continue to have mild tenderness. She is beginning functional weight-bearing activities. What modality is most appropriate? |
|
Definition
|
|
Term
| Refer to the following responses when answering this question. More than one answer is rational, but select the single best option: (1) ice pack, (2) moist heat pack, (3) cold whirlpool, (4) warm whirlpool, (5) contrast bath, (6) ultrasound at 1.0 MHz, (7) ultrasound at 3.0 MHz, (8) diathermy. At 3.5 weeks, the athlete complains of stiffness in her ankle. Reevaluation unveils scar tissue deposition in the sinus tarsi. What modality is most applicable? |
|
Definition
| (7) ultrasound at 3.0 MHz |
|
|
Term
| Athletic trainers commonly apply RICE (rest, ice, compression, and elevation) in the initial care of a musculoskeletal injury. An athlete presents immediately following an inversion ankle sprain. He reports that the ankle hurts and he is limping. Evaluation by the team physician yields a diagnosis of a Grade II lateral ankle sprain. Fluoroscopy is used to rule out fracture. Identify what actions you would take and instructions you would give this athlete about caring for this injury overnight, and identify what you are attempting to accomplish with your intervention. Provide specific physiological rationale necessary to defend your actions. |
|
Definition
| After ruling out existing contraindications for cold application, the injured ankle would be treated with an ice pack over the lateral ankle, wrapped with an elastic bandage, and elevated. The athlete would be instructed to use crutches to rest the injured ankle and to elevate the ankle while at rest. The athlete would also be instructed to repeat the ice application for 20 min every 1 to 2 h. The student's response should also address the physiological response to elevation (decreased hydrostatic pressure, enhanced lymphatic drainage), compression (may produce a counterpressure to the elevation in interstitial osmotic pressure caused by increase in free proteins), ice (decreases pain, may decrease capillary endothelial permeability), and rest (protects damaged soft tissue structures). |
|
|
Term
| All of the following should be addressed before advancing into sport specific training and functional rehabilitation EXCEPT |
|
Definition
a. AROM sufficiently restored
b. pain and swelling well controlled
c. restored strength
d. sources of persistent pain identified and treated
*e. all of the above are necessary to proceed |
|
|
Term
| All of the following can impair reflex response EXCEPT |
|
Definition
a. pain
b. swelling
c. damage to peripheral receptors
d. instability
*e. all of the above are correct |
|
|
Term
| A raw signal is modified through each of the following processes EXCEPT |
|
Definition
a. amplification
b. filtration
c. rectification
*d. intensification
e. integration |
|
|
Term
| All of the following are forms of biofeedback used in sport and rehabilitation EXCEPT |
|
Definition
*a. respiration monitors
b. heart rate monitors
c. visual feedback through mirrors
d. galvanic skin response measures
e. all of the above |
|
|
Term
| Which of the following is/are true regarding biofeedback? |
|
Definition
a. Biofeedback provides immediate feedback on changes in physiological or neural activity.
b. EMG biofeedback can be used to promote increases or decreases in neuromuscular activity.
c. EMG biofeedback is generally preferred over neuromuscular stimulation by the athlete/patient for neuromuscular reeducation.
d. a and b are correct.
*e. a, b, and c are correct. |
|
|
Term
| Which of the following represent(s) appropriate application of biofeedback? |
|
Definition
a. use of two mirrors to allow the injured athlete to view scapular positioning during therapeutic exercises
b. use of EMG biofeedback over the vastus medialis to improve muscle recruitment
c. use of EMG biofeedback over the upper trapezius as part of relaxation training
d. a and b are correct
*e. a, b, and c are correct |
|
|
Term
| Of the following, which statement best reflects the relationship between feedback and neuromuscular performance? |
|
Definition
a. Performance is best enhanced when feedback is general but provided rapidly.
b. Performance is best enhanced when feedback is specific but provided gradually.
c. Performance is best enhanced when feedback is general and provided gradually.
*d. Performance is best enhanced when feedback is specific and provided rapidly. |
|
|
Term
| The efficacy of EMG biofeedback in rehabilitation declines _________________ |
|
Definition
a. as movements become more rapid
b. as movements become more complex
c. when exercises are performed in a closed kinetic chain
*d. a and b are correct
e. a, b, and c are correct |
|
|
Term
| Neuromuscular control incorporates the afferent output to skeletal muscles with efferent neural input received by the CNS. |
|
Definition
|
|
Term
| ________________ incorporates the afferent output to skeletal muscles with efferent neural input received by the CNS. |
|
Definition
|
|
Term
| __________________ are rapidly generated muscle contractions in response to changes sensed in various receptors found in most tissues. |
|
Definition
|
|
Term
| ________________ is the use of instrumentation to bring physiological events to conscious awareness. |
|
Definition
|
|
Term
| _________________ permits the awareness of neural recruitment of muscles by transducing the electrical activity of a contracting muscle into visual and auditory signals. |
|
Definition
|
|
Term
| The mechanism responsible for not being able to contract the quadricep muscles following arthroscopic surgery is _______________ |
|
Definition
|
|
Term
| As the movement patterns during therapeutic exercise become more rapid and complex, the value of EMG biofeedback ________________. |
|
Definition
|
|
Term
| ________________ are exercises in which the distal segment is free to move. |
|
Definition
|
|
Term
| ________________ are exercises in which the distal segment is fixed in place. |
|
Definition
|
|
Term
| When taking the subjective report of the medical history, the clinician should ask about |
|
Definition
a. previous experience with treatments for injuries
b. rating of pain and dysfunction
c. activities that improve and worsen symptoms
d. location of pain
*e. all of the above are correct |
|
|
Term
| The clinician should observe for ____________ during a physical examination |
|
Definition
a. appearance of incisions
b. obvious guarding
c. presence of swelling
d. discoloration and wounds/scars
*e. all of the above are correct |
|
|
Term
| Treatments with therapeutic modalities can fail to cause improvement in patients when |
|
Definition
a. underlying structural lesions remain unidentified
*b. there is a loss of range of motion
c. rest-reinjury cycle exists
d. biomechanical flaws are overstressing tissues
e. pain is the result of psychological distress |
|
|
Term
| All of the following need to be addressed in the plan of treatment for MFPS EXCEPT |
|
Definition
a. contributions of stress and fatigue to pain
b. primary complaint of pain
c. progressive plan of therapeutic exercises
d. correction of faulty movement patterns
*e. all of the above need to be addressed
MFPS |
|
|
Term
| Of the following, which is/are viable options in the treatment of MFPS |
|
Definition
a. myofascial release techniques
b. TENS
*c. diathermy
d. superficial heat and cold
e. all of the above are viable options for treating MFPS |
|
|
Term
| Which of the following is the best explanation of the analgesic response to treatment of hypersensitive trigger points using a neuroprobe? |
|
Definition
* a. The electrical stimulus results in activation of a descending analgesic pathway and the release of enkephalin, which blocks transmission of impulses in the pain pathway.
b. The electrical stimulus results in inhibition of transmission of impulses to the transmission (T) cell due to increased activity of the substantia gelatinosa (SG) cell.
c. The electrical stimulus results in activation of a descending analgesic pathway and the release of beta-endorphin into the cerebrospinal fluid.
d. The electrical stimulation exhausts the ability of the nociceptive primary afferents to depolarize due to depletion of adenosine triphosphate (ATP). |
|
|
Term
| An athlete with sensitive trigger points is being treated with a neuroprobe. The athlete reports a burning, stinging sensation during electrical stimulation over each trigger point. Which of the following is/are true regarding the proposed physiological response to this treatment? |
|
Definition
a. The electrical stimulus is causing depolarization of C afferent fibers.
b. Enkephalin interneurons are being stimulated through a descending serotonergic pathway.
c. Enkephalin is interrupting (blocking) synaptic transmission between first-order and second-order nociceptive fibers.
d. a and b are correct.
*e. a, b, and c are correct. |
|
|
Term
| Trigger points are ____________________. |
|
Definition
a. bands of tight, hypersensitive connective tissue
b. associated with myofascial pain syndromes
c. tender to palpation
d. usually found bilaterally
*e. a, b, c, and d are correct |
|
|
Term
| Of the following, which is/are correct regarding the use of therapeutic modalities in the treatment of complex regional pain syndrome? |
|
Definition
*a. Treatment with a therapeutic modality is contraindicated if the treatment increases the pain experienced by the individual being treated.
b. Cold is the most effective modality in managing the pain associated with complex regional pain syndrome.
c. Complex regional pain syndrome is an absolute contraindication for treatment with electrotherapy.
d. a and b are correct.
e. a, b, and c are correct. |
|
|
Term
| Of the following, which treatment is most appropriate for management of myofascial pain syndrome? |
|
Definition
a. manual techniques to decrease pain and improve fascial mobility
b. treatments with TENS and ultrasound to decrease pain and improve fascial mobility
*c. a combination of treatment techniques that provide the greatest relief of symptoms |
|
|
Term
| The application of therapeutic modalities may hinder administration of definitive care by masking symptoms in which of the following persistent pain problems? |
|
Definition
a. rest-reinjury cycle
b. complex regional pain syndrome
c. myofascial pain syndrome
*d. a and b are correct
e. a, b, and c are correct |
|
|
Term
| Failure of an athlete to improve following treatments with therapeutic modalities and exercises _____________________. |
|
Definition
a. is strongly suggestive that secondary gain is a barrier to recovery
*b. is important information in the reevaluation of the injured athlete
c. is always due to diagnostic error
d. occurs only when modalities are applied improperly |
|
|
Term
| Of the following, which modality is most likely to be beneficial in the treatment of complex regional pain syndrome? |
|
Definition
*a. TENS
b. cryotherapy
c. EMG biofeedback
d. fluidotherapy |
|
|
Term
| The application of any modality constitutes a treatment and is therefore part of the comprehensive plan of care. |
|
Definition
|
|
Term
| 15. Individuals with chronic pain may relate an insidious onset of symptoms without an identifiable cause. |
|
Definition
|
|
Term
| It is much more difficult to obtain a medical history from a person suffering from persistent pain than from someone who just suffered an acute injury. |
|
Definition
|
|
Term
| The biomechanics of an activity is very closely linked to issues of the plan of care and to the rest-reinjury cycle. |
|
Definition
|
|
Term
| Therapeutic exercises are universal in the treatment plan of care for MFPS. |
|
Definition
|
|
Term
| The rehabilitation plan of care is developed from the medical history and ___________________. |
|
Definition
|
|
Term
| Probably the single largest problem with managing persistent pain is the failure to obtain, evaluate, and act upon a thorough _____________________. |
|
Definition
|
|
Term
| The ________________develops due to excessive stress to damaged tissues during both the repair and remodeling phases. |
|
Definition
|
|
Term
| ____________ is the warning that tissues are not able to handle the load placed upon them. |
|
Definition
|
|
Term
| _______________ is the key to breaking the rest-reinjury cycle. |
|
Definition
|
|
Term
| The most important role of the ATC in treating CRPS is ________________. |
|
Definition
|
|
Term
| All of the following are precautions or contraindications for myofascial release EXCEPT |
|
Definition
*a. extremely tender trigger points
b. recent fracture or surgery
c. pregnancy
d. joint instability or joint prosthesis
e. acute inflammation |
|
|
Term
| All of the following are precautions or contraindications for strain-counterstrain EXCEPT |
|
Definition
a. increased pain during treatment
b. recent fracture
c. presence of joint instability
d. none of the above
*e. all of the above |
|
|
Term
| All of the following are contraindications for muscle energy EXCEPT |
|
Definition
a. severe osteoporosis
b. joint fusion and joint instability
c. bony instability
*d. low back pain with muscle spasm
e. all of the above |
|
|
Term
| All of the following are contraindications for joint mobilization EXCEPT |
|
Definition
a. advanced osteoporosis
b. joint instability
c. bony instability and bone-to-bone end-feel
d. infection
*e. all of the above |
|
|
Term
| All of the following are contraindications for cervical traction EXCEPT |
|
Definition
a. positive alar ligament and vertebral artery test
b. increased pain or radicular symptoms with treatment
*c. hiatal hernia
d. advanced rheumatoid arthritis
e. all of the above |
|
|
Term
| All of the following are contraindications for lumbar traction EXCEPT |
|
Definition
a. pregnancy and claustrophobia
b. bone cancer and advanced osteoporosis
c. internal disc derangement
*d. previous history of thrombophlebitis
e. all of the above |
|
|
Term
| All of the following are contraindications for intermittent compression EXCEPT |
|
Definition
a. infection
b. acute fracture
c. pulmonary edema and congestive heart failure
*d. osteoarthritis
e. all of the above |
|
|
Term
| All of the following are correct about massage EXCEPT |
|
Definition
a. primary benefits include pain relief, reduced muscle spasm, and increased tissue extensibility
*b. increases superficial and deep blood flow
c. stimulates cutaneous receptors increasing input along large-diameter afferent pathways
d. analgesic effects partially attributed to gate control theory of pain modulation
e. c and d only |
|
|
Term
| All of the following are true about gamma gain as it relates to myofascial release EXCEPT |
|
Definition
a. the muscle in spasm becomes hypersensitive to stretch
b. hypersensitivity results from increased gamma efferent nerve stimulation of muscle spindles
c. cycles of pain, protective guarding, and fascial shortening gradually escalate
d. leads to myofascial pain
*e. all of the above |
|
|
Term
| All of the following are correct about strain-counterstrain EXCEPT |
|
Definition
a. technique used to reduce pain by arresting inappropriate proprioceptive activity
*b. directed toward treating the primary lesion rather than the dysfunction
c. results in increased pain-free ROM
d. includes both direct and indirect techniques
e. all of the above |
|
|
Term
| All of the following are correct about joint mobilization EXCEPT |
|
Definition
a. technique used to restore joint function
b. stimulates joint receptors and increases afferent input across large-diameter afferent fibers
*c. results in decreased pain and increased strength
d. subtle slides and glides are referred to as arthrokinematics
e. all of the above |
|
|
Term
| All of the following are correct about cervical traction EXCEPT |
|
Definition
a. indicated for cervical facet dysfunction, or disc pathology
*b. mechanical traction should be tried before manual traction
c. manual traction allows for the combination of other manual techniques
d. a and c only
e. all of the above |
|
|
Term
| All of the following are correct about manual cervical traction techniques EXCEPT |
|
Definition
a. patient is in a supine position
b. tension in the clinician's hands can diminish treatment effect
c. place head in the position of greatest comfort
d. side-bending is very good for relief of radicular symptoms
*e. all of the above |
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